Provider Demographics
NPI:1821680406
Name:MONCADA, JOSE J JR
Entity Type:Individual
Prefix:
First Name:JOSE
Middle Name:J
Last Name:MONCADA
Suffix:JR
Gender:M
Credentials:
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:8111 RESEDA BLVD APT 107
Mailing Address - Street 2:
Mailing Address - City:RESEDA
Mailing Address - State:CA
Mailing Address - Zip Code:91335-1201
Mailing Address - Country:US
Mailing Address - Phone:818-518-0851
Mailing Address - Fax:
Practice Address - Street 1:8111 RESEDA BLVD APT 107
Practice Address - Street 2:
Practice Address - City:RESEDA
Practice Address - State:CA
Practice Address - Zip Code:91335-1201
Practice Address - Country:US
Practice Address - Phone:818-518-0851
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2021-02-05
Last Update Date:2021-02-05
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes106S00000XBehavioral Health & Social Service ProvidersBehavior Technician